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Self-help for bulimia nervosa: a randomized controlled trial.
Am J Psychiatry 2003; 160(5):973-8AJ

Abstract

OBJECTIVE

The authors examined the effectiveness of unguided self-help as a first step in the treatment of bulimia nervosa.

METHOD

A total of 85 women with bulimia nervosa who were on a waiting list for treatment at a hospital-based clinic participated. The patients were randomly assigned to receive one of two self-help manuals or to a waiting list control condition for 8 weeks. One of the self-help manuals addressed the specific symptoms of bulimia nervosa (cognitive behavior self-help), while the other focused on self-assertion skills (nonspecific self-help).

RESULTS

Twenty patients (23.5%) dropped out of the study. The data were analyzed with intention-to-treat analysis. Although the group-by-time interaction for binge eating and purging was not statistically significant, simple effects showed that there was a significant reduction in symptom frequency in both self-help conditions at posttreatment but not in the waiting list condition. There were no statistically significant changes in levels of dietary restraint, eating concerns, concerns about shape and weight, or general psychopathology. A greater proportion of patients in the cognitive behavior self-help (53.6%) and nonspecific self-help (50.0%) conditions reported at least a 50% reduction in binge eating or purging at posttreatment, compared with the waiting list condition (31.0%). A lower baseline knowledge about eating disorders, more problems with intimacy, and higher compulsivity scores predicted a better response.

CONCLUSIONS

The findings suggest that a subgroup of patients with bulimia nervosa may benefit from unguided self-help as a first step in their treatment. Cognitive behavior self-help and nonspecific self-help had equivalent effects.

Authors+Show Affiliations

Department of Psychiatry, Toronto General Hospital, 200 Elizabeth Street, Eaton Wing B-231, Toronto, Ontario M5G 2C4, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12727703

Citation

Carter, Jacqueline C., et al. "Self-help for Bulimia Nervosa: a Randomized Controlled Trial." The American Journal of Psychiatry, vol. 160, no. 5, 2003, pp. 973-8.
Carter JC, Olmsted MP, Kaplan AS, et al. Self-help for bulimia nervosa: a randomized controlled trial. Am J Psychiatry. 2003;160(5):973-8.
Carter, J. C., Olmsted, M. P., Kaplan, A. S., McCabe, R. E., Mills, J. S., & Aimé, A. (2003). Self-help for bulimia nervosa: a randomized controlled trial. The American Journal of Psychiatry, 160(5), pp. 973-8.
Carter JC, et al. Self-help for Bulimia Nervosa: a Randomized Controlled Trial. Am J Psychiatry. 2003;160(5):973-8. PubMed PMID: 12727703.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-help for bulimia nervosa: a randomized controlled trial. AU - Carter,Jacqueline C, AU - Olmsted,Marion P, AU - Kaplan,Allan S, AU - McCabe,Randi E, AU - Mills,Jennifer S, AU - Aimé,Annie, PY - 2003/5/3/pubmed PY - 2003/6/18/medline PY - 2003/5/3/entrez SP - 973 EP - 8 JF - The American journal of psychiatry JO - Am J Psychiatry VL - 160 IS - 5 N2 - OBJECTIVE: The authors examined the effectiveness of unguided self-help as a first step in the treatment of bulimia nervosa. METHOD: A total of 85 women with bulimia nervosa who were on a waiting list for treatment at a hospital-based clinic participated. The patients were randomly assigned to receive one of two self-help manuals or to a waiting list control condition for 8 weeks. One of the self-help manuals addressed the specific symptoms of bulimia nervosa (cognitive behavior self-help), while the other focused on self-assertion skills (nonspecific self-help). RESULTS: Twenty patients (23.5%) dropped out of the study. The data were analyzed with intention-to-treat analysis. Although the group-by-time interaction for binge eating and purging was not statistically significant, simple effects showed that there was a significant reduction in symptom frequency in both self-help conditions at posttreatment but not in the waiting list condition. There were no statistically significant changes in levels of dietary restraint, eating concerns, concerns about shape and weight, or general psychopathology. A greater proportion of patients in the cognitive behavior self-help (53.6%) and nonspecific self-help (50.0%) conditions reported at least a 50% reduction in binge eating or purging at posttreatment, compared with the waiting list condition (31.0%). A lower baseline knowledge about eating disorders, more problems with intimacy, and higher compulsivity scores predicted a better response. CONCLUSIONS: The findings suggest that a subgroup of patients with bulimia nervosa may benefit from unguided self-help as a first step in their treatment. Cognitive behavior self-help and nonspecific self-help had equivalent effects. SN - 0002-953X UR - https://www.unboundmedicine.com/medline/citation/12727703/full_citation L2 - https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.160.5.973?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -